Provider Demographics
NPI:1780394221
Name:DE PAULA, RUDY D
Entity type:Individual
Prefix:
First Name:RUDY
Middle Name:D
Last Name:DE PAULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 WHITE PLAINS RD APT 1G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1433
Mailing Address - Country:US
Mailing Address - Phone:646-944-5455
Mailing Address - Fax:
Practice Address - Street 1:1816 WHITE PLAINS RD APT 1G
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1433
Practice Address - Country:US
Practice Address - Phone:646-944-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst